Dentists are given 24 hours’ notice to prepare for a free dental policy
The British Dental Association Scotland has warned the Scottish government to improve communication and carefully manage patient expectations, as it today instructed boards of health on providing free NHS dental care to 18 -25 years old, just one working day before the policy takes effect Tuesday.
Instructions are unlikely to reach practices until next week.
Politics was a centerpiece of the SNP’s election candidacy in May, and plans to abolish dental fees for this age group were introduced more than two months ago. Today’s communication is the first formal instruction on how the practices should implement the policy.
Many practices will simply be unable to make the required changes in such a short time. The timing of the eleventh hour has all but ruled out the possibility of providing the necessary training to staff for the new arrangements, as well as the possibility of introducing appropriate practice management systems.
BDA Scotland also expressed deep concern about the lack of clear messages to manage patient expectations. Practices continue to operate at low capacity due to ongoing COVID restrictions, with no ability to meet an anticipated increase in demand.
Analysis of access to information requests made by the BDA indicates that more than 4 million appointments have been lost since the first lockdown in Scotland, compared to pre-COVID levels, with only 25% of usual volumes of dental care provided. As of April 2021, the service was offering less than half of the treatments it offered in any given month before the pandemic. 
Scotland already offers free dental exams from the NHS. Official pre-pandemic data showed Scotland had 25% higher adult participation rates than England, hinting at the magnitude of the demand suppression effects of fees, which according to the BDA, are the wrong way to fund NHS dentistry. The new policy’s activity assessment document indicates that additional costs may arise due to increased processing of service items, but this is “not quantifiable”.
While BDA representatives briefly discussed the change with the Cabinet Secretary in June, during which they stressed the need for a clear public message, the Scottish government has acknowledged that no formal public or commercial consultation on this policy had not been undertaken.
David McColl, chairman of the Scottish Dental Practice Committee of the British Dental Association, said: “It is beyond belief that practices have been given a single day’s work to prepare for a sea change in the way dentistry works. is provided in Scotland.
“The roll-out of free dentistry will inevitably increase patient expectations and increase pressure on dental teams who are already struggling to cope with a colossal backlog.
“Ministers risk creating a demand for care that simply cannot be met and must clearly communicate what is available and what is not. Failure to do so will only leave hard-pressed colleagues bearing the brunt of patient frustrations.
“The Scottish government has not fully understood how dental practice works throughout this pandemic.
“We need better communication and appropriate investments. This is not the way to implement a historical policy.
Number of treatment courses (COT), per month and year paid by general dental services in Scotland; January 2019 to April 2021
|March||373 208||45,734||418 942|
|May||398,419||44 687||443 106|
|June||344 762||39 352||384,114|
|October||382 284||45 104||427,388|
|April||10 185||1,658||11 843|
|May||7 138||917||8 055|
|July||82 570||8 936||91 506|
|August||79,878||8 344||88 222|
|September||91 817||9,067||100 884|
|2021||January||126 103||17,069||143 172|
|Average TOC per month before COVID||360,778||41,701||402,479|
|Likely TOC in the absence of COVID||5,050,893||583,811||5,634,704|
|Actual TOC during a pandemic||1,295,579||150 194||1 445 773|
|Estimated missed TOC||3,755,314||433 617||4 188 931|
|TOC missed as% of potential activity||74.35%||74.27%||74.34%|